While the Feb. 4, editorial, “The ACA is working in NC despite Blue Cross losses,” was correct in stating that the Affordable Care Act has reduced the number uninsured North Carolinians, it did not address the challenges it has exacerbated related to health care costs.
We’ve always believed that North Carolinians should have access to quality care. The ACA has provided an important step toward that goal by expanding access to hundreds of thousands of people in our state.
However, the ACA failed to address the underlying costs of care, which have steadily skyrocketed in North Carolina. This failure to address costs is a serious flaw in the law.
Blue Cross’ ACA customers have been older and less healthy than our pre-ACA customers and lacked the balance necessary for stable rates. They use far more in care than others, making this group more expensive to cover. As a result, we’ve had to drastically increase rates for our ACA customers each year.
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The editorial was correct in pointing out that the federal government created programs to reimburse insurers for potential losses during the first few years. However, most of the programs last only three years, and the risk corridor program was woefully underfunded.
Nationally, the government has paid only a small fraction of the amount owed to insurers. The risk corridor program is supposed to be funded by insurers that make profits in ACA business, but so many insurers have lost money that the program has not collected enough money to meet its obligations. As a result, Blue Cross received $130 million less in risk corridor reimbursements than it was owed for 2014, and it will likely face a much larger shortfall in 2015.
Yes, we’ve expanded access, but we have to do more – much more – to make health care affordable.
It’s clear that the ACA requires changes if it is to become a sustainable business model. No business can sustain losses like this. Even worse, North Carolinians shouldn’t have to pay double-digit rate increases each year to ensure the law works as intended.
Fundamental changes must occur to ensure that all North Carolinians can afford health insurance. It’s urgent to continue this discussion about how North Carolina’s public and private sectors can work together to make these changes happen, and those who offer serious suggestions about how to improve the law should not be labeled as “alarmist.”
CEO and president, Blue Cross and Blue Shield of North Carolina
The length limit was waived to permit a fuller response to the editorial.